In June I told you in this blog that “all children should be screened for high cholesterol when they’re 9 to 11 years old according to new guidelines from the National Lipid Association (NLA).” I mentioned then that there would be more guidelines “in the fall. So, stay tuned.” Well now those new recommendations are out: Continue reading →

A dietary intervention study of cholesterol-lowering foods with either two or seven counseling sessions significantly lowered LDL cholesterol (the lethal or bad cholesterol) compared with a control diet emphasizing reduced saturated fat consumption. The results between the groups receiving two versus seven counseling sessions were not significantly different. The bottom line? Cholesterol lowering foods are more highly healthy than a low fat diet. Continue reading →

The Chicago Tribune “Julie’s Health Club” blog reported that “some red yeast rice products have been shown to lower cholesterol levels as effectively as moderate doses of statin drugs.” However, “the supplement isn’t quite ‘ready for primetime,’ according to researchers who found that 12 over-the-counter red yeast products had strikingly inconsistent amounts of active ingredients.”

The research, “published in the current issue of the Archives of Internal Medicine, also showed that four of the 12 products (one third of the sample) contained citrinin, a contaminant that is toxic to kidneys of animals.” WebMD and MedPage Today also covered the story.

It for this reason that I do NOT recommend anyone take red yeast rice. In addition to the above study, a recent analysis by ConsumerLab found red yeast rice products varied sharply in their potency, and some were contaminated with a toxic byproduct called citrinin.

This is not true of the prescription statins, which are regulated by the FDA. And, with prescription drugs you can be sure:

There are no contaminants,

The pills are the same from bottle to bottle,

The pills can be absorbed into your body, and

The pills are made with an approved manufacturing process.

Unfortunately, in the U.S., the same is not true of most supplements.

Furthermore, generic statins are available at most pharmacies for $4 for a month’s supply or $10 for a three-month’s supply. That’s much, much less expensive that red yeast rice supplements.

However, there is one protection for the American consumer, when it comes to dietary supplements – and that is to see if it has been evaluated by an independent testing lab. And the lab that has tested more supplements than any other is ConsumerLab. Check them out.

For the last couple of years, I’ve been offering my adolescent patients the option of checking their lipid panels, especially if they are overweight or obese. Now, new research is showing the wisdom of this approach. The Wall Street Journal reports that research published in the Annals of Family Medicine suggests that even younger people should pay attention to their cholesterol levels, being that they may have an impact on health later in life.

The Los Angeles Times “Booster Shots” blog reported that researchers “analyzed data from 3,258 men and women who have been tracked by the CARDIA , or Coronary Artery Risk Development in Young Adults, study for the last 20 years and were ages 18 to 30 at the start of the study.”

The investigators “found that participants with histories of high levels of the ‘bad’ LDL cholesterol were five and a half times as likely to have a buildup of calcium in their coronary arteries … than those who had optimal LDL cholesterol levels.”

The researchers also found that “rates of coronary calcium buildup were also higher in those who had suboptimal levels of the so-called ‘good’ cholesterol, high density lipoprotein, or HDL cholesterol, although this association was weaker.”

The New York Times reports in Vital Signs that “young adults tend to be notoriously lax about preventive health care, and cholesterol screening is no exception,” according to the new study.

Barely “half of all young men and women are screened for high LDL, the so-called bad cholesterol,” according to the study by the CDC’s Elena Kuklina and others.

The research was based on “analysis of data on 2,587 young adults — including men aged 20 to 35 and women aged 20 to 45.”

Kuklina said “young adults should be screened, because heart disease is a chronic condition that can begin damaging blood vessels at an early age.”

In our practice we’ve certainly found scores of kids with surprisingly abnormal lipid panels. I, my patients, and their parents are certainly glad we did.

According to a report in the Wall Street Journal research published in the Archives of Internal Medicine suggests that nuts may help lower cholesterol levels.

HealthDay reported that investigators “pooled data on 583 men and women who had participated in 25 nut consumption trials.”

“Patients in the trials ate an average of 67 grams, or about 2.4 ounces, of nuts daily,” WebMD reported. While MedPage Today reported that the researchers found that “eating an average of 67 grams of nuts a day (2.4 ounces) reduced total cholesterol by 5.9% and LDL cholesterol by 7.4%.”

The bottom line, a couple of ounces of nuts per day may be heart healthy and highly healthy.

Almost half of American adults, 45% of us, now have high blood pressure, high cholesterol, or diabetes, according to a report from researchers from the national Centers for Disease Control and Prevention.

The Los Angeles Times reports that “one in eight Americans has at least two of the conditions and one in 33 has all three, sharply increasing their risk.” These “data come from the ongoing National Health and Nutrition Examination Survey.”

While “researchers should be able to use the new data to plan interventions, ‘the main thing here is for people to be aware that they have these conditions and know that lifestyle modifications and medications can control them and reduce their risk for cardiovascular disease,’ said epidemiologist Cheryl D. Fryar of the CDC’s National Center for Health Statistics, one of the study’s authors.”

WebMD reported that “the study shows that about 8% of adults have undiagnosed high blood pressure, 8% have undiagnosed high cholesterol, and 3% of have undiagnosed diabetes.”

HealthDay reported that “blacks had a particularly high incidence of hypertension, 42.5 percent, compared to 29.1 percent of non-Hispanic whites and 26.1 percent of Mexican-Americans.”

The report indicated that “high blood cholesterol was more common among non-Hispanic whites (26.9 percent) than among blacks (21.5 percent) and Mexican-Americans (21.8 percent), while diabetes was more common among blacks (14.6 percent) and Mexican-Americans (15.3 percent) than among non-Hispanic whites (8.3 percent).”

“The number that really surprises me is the penetration of these conditions into the U.S. population,” Dr. Clyde Yancy of Baylor University Medical Center, president of the American Heart Association, told the LA Times.

“When that number is nearly 50%, that’s a huge wake-up call.” It means there are a large number of people “who think they are healthy…but are working under a terrible misconception.”

“This report is so timely and important because it crystallizes exactly what the burden is,” Yancy said. “It tells us the challenge we now face that could stress and potentially defeat any healthcare system we could come up with.”

Personal responsibility plays a big role in creating these three health problems, he said. “This trio begins with a quartet of smoking, a junk diet, physical inactivity and obesity. Those are all things we can do something about.”

According to a report in HealthDay, the CDC survey doesn’t attempt to learn the reason why the incidence of these major risk factors is so high.

Dr. Clyde W. Yancy, medical director of the Baylor Heart and Vascular Institute at Baylor University Medical Center, and president of the American Heart Association, told HealthDay he thinks he knows the reason: obesity.

“The burden of risk is directly related to the burden of obesity,” Yancy said. “Obesity is directly related to high blood pressure, directly related to diabetes, directly related to an abnormal lipid profile.”

And with 60 percent of adult Americans and 30 percent of younger Americans overweight or obese, the burden threatens to become worse, he said.

While the message about obesity and what causes it – lack of exercise, poor diet, overeating – is sent repeatedly, “people don’t get it,” Yancy said. “They are putting us at the risk of having a generation of Americans that has worse health than the previous generation, which has never happened before,” he said.

The CDC report is “a call to arms,” Yancy said. “Targeting obesity should now be on the top of the radar screen for everybody.”

So, what should you do about this?

This is what I recommend to my adult patients: Have a preventive medicine visit every 3-5 years in your 20’s, every three years in your 30’s, every two years in your 40’s, and every year after age 50.

As far as these disorders, be sure at each of these visits to have the following items checked:

There’s good news for men concerned about developing prostate cancer. The AP reports, “Men may protect more than their hearts if they keep cholesterol in line: Their chances of getting aggressive prostate cancer may be lower.” Want to learn more? Then, read on as scientists at two institutions have detailed the research that led them to that conclusion in Cancer Epidemiology Biomarkers & Prevention.

According to the AP report, even though the papers “are not definitive and have some weaknesses,” they do “fit with plenty of other science suggesting that limiting fats in the bloodstream can lessen cancer risk.”

HealthDay reported that NCI investigators reviewed “data from a study that has followed more than 29,000 Finnish men for 18 years,” finding that “cholesterol levels below the generally recommended 200 milligrams per deciliter were associated with an 18 percent higher overall risk of cancer.”

Two studies looked at cholesterol in cancer finding that low cholesterol is a symptom rather than a cause and that low cholesterol may actually lower a man’s risk of high-grade prostate cancer.

In the first study, researchers observed over 29,000 men for 18 years for cancer and found no association unless they included men who were diagnosed right away after enrolling in the trial.

These men likely already had cancer and their low cholesterol was an effect and not a cause, since all the other men didn’t develop cancers at a rate different from men with normal or high cholesterol.

The second study found an association between low cholesterol and lower than average risk for high-grade prostate cancer, however we need to see the results of a clinical trial looking at the effects of lowering cholesterol on cancer risk before there will be recommendations for drugs like statins to be used preventively.

An editorial in same issue of Cancer Epidemiology, Biomarkers & Prevention concluded, “Results from the two analyses of cholesterol and risk of cancer published in this issue . . . clearly show that low total cholesterol is unlikely to increase risk of cancer.”

The editorial also makes this interesting observation: “If results of such observational studies support the hypothesis that low cholesterol inhibits prostate cancer progression, then it would raise the question of whether prostate cancer patients choosing active surveillance, rather than immediate treatment, could reduce their risk of disease progression by using statins or other cholesterol lowering drugs. This question, however, would need to be answered by a randomized trial.”

So, the bottom line?

Guys, get a lipid profile and if it’s abnormal do what you must do to get it normal — whether that’s changing your nutrition, increasing your physical activity, or using cholesterol lowering drugs.

Ladies, get the guys you love to have a lipid profile. If it’s abnormal, follow the advice above.

Reuters Health is reporting new research showing that a regimen of supplements and lifestyle coaching is just as effective as a statin medication for reducing levels of low-density lipoprotein (LDL) or “lethal” cholesterol. Not only that, the combination was shown to be more effective in helping people lose weight.